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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 5210 Introduced in Senate (IS)]

<DOC>

118th CONGRESS
  2d Session
                                S. 5210

    To improve mental health services of the Department of Veterans 
                    Affairs, and for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                           September 25, 2024

  Mr. Tester introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL

 
    To improve mental health services of the Department of Veterans 
                    Affairs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Building Resources 
and Access for Veterans' Mental Health Engagement Act of 2024'' or the 
``BRAVE Act of 2024''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
   TITLE I--IMPROVEMENT OF WORKFORCE IN SUPPORT OF MENTAL HEALTH CARE

Sec. 101. Report on market pay surveys for Readjustment Counseling 
                            Service positions.
Sec. 102. Qualifications of appointees in occupations that support 
                            mental health programs.
Sec. 103. Report on coordination of Veterans Health Administration with 
                            Readjustment Counseling Service.
   TITLE II--IMPROVEMENT OF VET CENTER INFRASTRUCTURE AND TECHNOLOGY

Sec. 201. Vet Center defined.
Sec. 202. Comptroller General report on Readjustment Counseling Service 
                            model for expansion of Vet Center 
                            footprint.
Sec. 203. Improvement of guidance and information to improve veteran 
                            outreach efforts by Vet Centers.
Sec. 204. Report on information technology system of Readjustment 
                            Counseling Service.
                       TITLE III--WOMEN VETERANS

Sec. 301. Study on effectiveness of suicide prevention and mental 
                            health outreach programs of Department of 
                            Veterans Affairs for women veterans.
Sec. 302. Requirement for Department of Veterans Affairs to modify the 
                            REACH VET program to incorporate risk 
                            factors weighted for women veterans.
Sec. 303. Review of and report on reintegration and readjustment 
                            services for veterans and family members in 
                            group retreat settings.
                        TITLE IV--OTHER MATTERS

Sec. 401. Extension of Staff Sergeant Parker Gordon Fox Suicide 
                            Prevention Grant Program.
Sec. 402. Access to mental health residential rehabilitation treatment 
                            programs for veterans with spinal cord 
                            injury or disorder.
Sec. 403. Mental health consultations and outreach on mental health 
                            services for veterans receiving 
                            compensation for disabilities relating to 
                            mental health diagnoses.
Sec. 404. Joint report on effectiveness of programs of Department of 
                            Veterans Affairs and Department of Defense 
                            that promote access to mental health 
                            services for transitioning members of the 
                            Armed Forces.

   TITLE I--IMPROVEMENT OF WORKFORCE IN SUPPORT OF MENTAL HEALTH CARE

SEC. 101. REPORT ON MARKET PAY SURVEYS FOR READJUSTMENT COUNSELING 
              SERVICE POSITIONS.

    (a) Findings.--Congress finds that the Secretary of Veterans 
Affairs, through the Chief Readjustment Counseling Officer, reviews 
market pay surveys in each Readjustment Counseling Service District to 
compare the salaries of employees in the Readjustment Counseling 
Service of the Department of Veterans Affairs, including licensed 
professional mental health counselors, social workers, and marriage and 
family therapists, to the salaries of similarly situated employees 
within the Department and the private sector.
    (b) Report.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report on the findings specified in 
subsection (a), which shall--
            (1) include an assessment of pay disparities between 
        employees of the Readjustment Counseling Service of the 
        Department and similarly situated employees within the 
        Department and the private sector; and
            (2) identify if pay-related staffing challenges exist, and 
        if so, determine if each Readjustment Counseling Service 
        District has initiated a review of third-party survey data for 
        the identified occupations.
    (c) Districts.--Each report submitted under subsection (b) shall 
include reports from all Readjustment Counseling Service Districts of 
the Department, including--
            (1) areas that are geographically diverse;
            (2) rural areas;
            (3) highly rural areas;
            (4) urban areas; and
            (5) areas with health care shortages.
    (d) Assessment of Pay.--Each report submitted under subsection (b) 
shall include an assessment of pay based on the following factors:
            (1) Third-party survey data.
            (2) Geographic location.
            (3) Equivalent qualifications (licensure, education level, 
        or experience).
            (4) Short-term incentives.

SEC. 102. QUALIFICATIONS OF APPOINTEES IN OCCUPATIONS THAT SUPPORT 
              MENTAL HEALTH PROGRAMS.

    (a) Psychologists.--Section 7402(b)(8)(C) of title 38, United 
States Code, is amended by striking ``for a period not to exceed'' and 
all that follows through the period at the end and inserting ``for a 
reasonable period of time recommended by the Under Secretary for 
Health.''.
    (b) Licensed Professional Mental Health Counselors.--Section 
7402(b)(11)(B) of title 38, United States Code, is amended by striking 
the period at the end and inserting ``, except that the Secretary may 
waive the requirement of licensure or certification for an individual 
licensed professional mental health counselor for a reasonable period 
of time recommended by the Under Secretary for Health.''.

SEC. 103. REPORT ON COORDINATION OF VETERANS HEALTH ADMINISTRATION WITH 
              READJUSTMENT COUNSELING SERVICE.

    (a) In General.--Not later than 60 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
to the Committee on Veterans' Affairs of the Senate and the Committee 
on Veterans' Affairs of the House of Representatives a report regarding 
coordination between the clinical care system of the Veterans Health 
Administration and the Readjustment Counseling Service of the 
Department of Veterans Affairs.
    (b) Assessment.--The report required by subsection (a) shall 
include an assessment of the adherence by each Director of a Veterans 
Integrated Service Network to policies of the Veterans Health 
Administration, which require each such Director to ensure that a 
support facility of the Department of Veterans Affairs is aligned 
laterally with each Vet Center to provide supportive administrative and 
clinical collaboration to better serve veterans eligible for services 
from Vet Centers, particularly those at high risk for suicide.
    (c) Analysis.--The report required by subsection (a) shall include 
an analysis of--
            (1) whether staff at Vet Centers in the local area of a 
        medical facility of the Department have the updated contact 
        information for appropriate staff at the medical facility to 
        ensure proper coordination of care;
            (2) whether the external clinical consultant and suicide 
        prevention coordinator of a medical facility of the Department 
        are providing counseling staff of each Vet Center in the local 
        area of the medical facility professional consultation not less 
        frequently than monthly through regularly scheduled peer case 
        presentations onsite at the Vet Center or via virtual or 
        telephone consultation as necessary to fully support the 
        coordination of care of patients, particularly those at high 
        risk for suicide;
            (3) whether the external clinical consultant and suicide 
        prevention coordinator are documenting any consultation 
        conducted under paragraph (2); and
            (4) whether the Under Secretary for Health is coordinating 
        with the Outreach Specialist at each Vet Center to ensure 
        active duty members of the Armed Forces who are participating 
        in the Transition Assistance Program of the Department of 
        Defense are provided information regarding Vet Centers and the 
        services provided at Vet Centers.
    (d) Vet Center Defined.--In this section, the term ``Vet Center'' 
has the meaning given that term in section 1712A(h) of title 38, United 
States Code.

   TITLE II--IMPROVEMENT OF VET CENTER INFRASTRUCTURE AND TECHNOLOGY

SEC. 201. VET CENTER DEFINED.

    In this title, the term ``Vet Center'' has the meaning given that 
term in section 1712A(h) of title 38, United States Code.

SEC. 202. COMPTROLLER GENERAL REPORT ON READJUSTMENT COUNSELING SERVICE 
              MODEL FOR EXPANSION OF VET CENTER FOOTPRINT.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Committee on Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of the House of Representatives a 
report assessing the model used by the Readjustment Counseling Service 
of the Department of Veterans Affairs to guide the expansion of the 
real property footprint of Vet Centers.
    (b) Elements.--The report required by subsection (a) shall assess--
            (1) whether the model described in such subsection 
        adequately accounts for the demand for Vet Center services in 
        rural areas;
            (2) whether the frequency with which the Secretary of 
        Veterans Affairs is reassessing areas for potential expansion 
        of Vet Center services is often enough to address any 
        population shifts;
            (3) whether such model adequately considers the needs of 
        veterans in areas with high rates of calls to the Veterans 
        Crisis Line or high rates of suicide by veterans or members of 
        the Armed Forces;
            (4) whether such model adequately accounts for trends in 
        usage of mobile Vet Centers in a given area; and
            (5) whether such model takes into account the unique needs 
        of veterans and members of the Armed Forces in areas being 
        assessed.
    (c) Veterans Crisis Line.--In this section, the term ``Veterans 
Crisis Line'' means the toll-free hotline for veterans established 
under section 1720F(h) of title 38, United States Code.

SEC. 203. IMPROVEMENT OF GUIDANCE AND INFORMATION TO IMPROVE VETERAN 
              OUTREACH EFFORTS BY VET CENTERS.

    Not later than 180 days after the date of the enactment of this 
Act, the Secretary of Veterans Affairs shall--
            (1) ensure each Vet Center has demographic data, such as 
        age, gender, race, and ethnicity, for individuals eligible for 
        Vet Center services in the service area of such Vet Center to 
        be used to tailor outreach activities, including data on 
        veterans who have recently transitioned from service in the 
        Armed Forces;
            (2) provide Vet Centers with guidance for assessing the 
        effectiveness of outreach activities, including guidance on 
        metrics for those activities and targets against which to 
        assess those metrics to determine effectiveness;
            (3) develop and implement a process to periodically assess 
        the extent to which veterans and members of the Armed Forces 
        who are eligible for services from Vet Centers experience 
        barriers to obtaining such services, including a lack of 
        awareness about Vet Centers and challenges accessing Vet Center 
        services; and
            (4) develop and implement a process to periodically assess 
        the extent to which staff of Vet Centers may encounter barriers 
        to providing services.

SEC. 204. REPORT ON INFORMATION TECHNOLOGY SYSTEM OF READJUSTMENT 
              COUNSELING SERVICE.

    Not later than 60 days after the date of the enactment of this Act, 
the Secretary of Veterans Affairs, through the Chief Readjustment 
Counseling Officer of the Veterans Health Administration, shall submit 
to the Committee on Veterans' Affairs of the Senate and the Committee 
on Veterans' Affairs of the House of Representatives a report 
identifying--
            (1) whether the Department of Veterans Affairs is retaining 
        or replacing the current information technology platform of the 
        Department, commonly referred to as ``RCSNet'', which is 
        currently used to manage certain parts of the daily work of 
        employees of the Readjustment Counseling Service and 
        operational data and management functions of the Readjustment 
        Counseling Service;
            (2) if the Department intends to keep RCSNet, the rationale 
        for that decision and an identification of the steps the 
        Department is taking to maintain or improve the functionality 
        of RCSNet and the timeline for those steps; and
            (3) if the Department intends to replace RCSNet, the 
        rationale for that decision and an identification of the steps 
        the Department is taking to implement that replacement, 
        including a timeline and the estimated cost for that 
        replacement.

                       TITLE III--WOMEN VETERANS

SEC. 301. STUDY ON EFFECTIVENESS OF SUICIDE PREVENTION AND MENTAL 
              HEALTH OUTREACH PROGRAMS OF DEPARTMENT OF VETERANS 
              AFFAIRS FOR WOMEN VETERANS.

    (a) In General.--Not later than 240 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall conduct 
surveys and host listening sessions with women veterans to determine 
the extent to which--
            (1) suicide prevention, lethal-means safety, and mental 
        health resources and messaging campaigns of the Department of 
        Veterans Affairs are perceived and accepted by women veterans;
            (2) women veterans find those resources and messaging 
        campaigns effective and sufficiently tailored to women 
        veterans;
            (3) the integration into those resources and messaging 
        campaigns of information pertaining to military sexual trauma, 
        intimate partner violence, and trauma-informed health care 
        would make those resources and messaging campaigns more 
        effective for women veterans;
            (4) the Department could make additional improvements to 
        those resources and messaging campaigns, including the Women's 
        Health Transition Training Program, to make those resources and 
        messaging campaigns more effective for women veterans; and
            (5) programs and services of the Department are targeted at 
        women veterans of different ages and eras of services, racial 
        and ethnic backgrounds, and geographical areas.
    (b) Population Studied.--The Secretary shall conduct the surveys 
and listening sessions required under subsection (a) in urban and rural 
areas and shall ensure such surveys and listening sessions are targeted 
at different demographics.
    (c) Report.--Not later than one year after the surveys and 
listening sessions required under subsection (a) are complete, the 
Secretary shall submit to the Committee on Veterans' Affairs of the 
Senate and the Committee on Veterans' Affairs of the House of 
Representatives a report on the findings of such surveys and listening 
sessions, which shall document the steps the Secretary intends to take 
to refine the suicide prevention, lethal-means safety, and mental 
health resources and messaging campaigns of the Department based on the 
feedback from such surveys and listening sessions to ensure the 
Secretary is utilizing the most effective strategies.

SEC. 302. REQUIREMENT FOR DEPARTMENT OF VETERANS AFFAIRS TO MODIFY THE 
              REACH VET PROGRAM TO INCORPORATE RISK FACTORS WEIGHTED 
              FOR WOMEN VETERANS.

    Not later than 60 days after the date of the enactment of this Act, 
the Secretary of Veterans Affairs shall initiate efforts to modify the 
Recovery Engagement and Coordination for Health-Veterans Enhanced 
Treatment program (``REACH VET'') to incorporate into such program risk 
factors weighted for women, such as military sexual trauma and intimate 
partner violence.

SEC. 303. REVIEW OF AND REPORT ON REINTEGRATION AND READJUSTMENT 
              SERVICES FOR VETERANS AND FAMILY MEMBERS IN GROUP RETREAT 
              SETTINGS.

    (a) Review.--Not later than 60 days after the date of the enactment 
of this Act, the Secretary of Veterans Affairs shall review all 
requests for reintegration and readjustment services for veterans and 
family members of veterans in group retreat program settings under 
section 1712A(a)(1)(B)(ii) of title 38, United States Code, to 
determine if current retreat programming meets demand, specifically 
requests for--
            (1) women only retreats;
            (2) disabled access retreats, particularly wheelchair 
        accessible retreats; and
            (3) retreats for veterans with specific medical needs.
    (b) Report.--Not later than 120 days after the date of the 
enactment of this Act, the Secretary shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report on whether the provision by 
the Secretary of reintegration and readjustment services for veterans 
and family members of veterans in group retreat program settings should 
be increased and made permanent, including--
            (1) women only retreats;
            (2) disabled access retreats, particularly wheelchair 
        accessible retreats; and
            (3) retreats for veterans with specific medical needs.

                        TITLE IV--OTHER MATTERS

SEC. 401. EXTENSION OF STAFF SERGEANT PARKER GORDON FOX SUICIDE 
              PREVENTION GRANT PROGRAM.

    Section 201 of the Commander John Scott Hannon Veterans Mental 
Health Care Improvement Act of 2019 (Public Law 116-171; 38 U.S.C. 
1720F note) is amended--
            (1) in subsection (c)(2)(A), by striking ``$750,000'' and 
        inserting ``$1,000,000''; and
            (2) in subsection (j), by striking ``three years'' and 
        inserting ``six years''.

SEC. 402. ACCESS TO MENTAL HEALTH RESIDENTIAL REHABILITATION TREATMENT 
              PROGRAMS FOR VETERANS WITH SPINAL CORD INJURY OR 
              DISORDER.

    (a) Plan.--
            (1) In general.--Not later than 60 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall submit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives a plan to ensure access to mental health 
        residential treatment programs of the Department of Veterans 
        Affairs for veterans with a spinal cord injury or disorder.
            (2) Elements.--The plan required under paragraph (1) shall 
        include--
                    (A) a staffing plan, which shall include a plan for 
                how the Department will--
                            (i) incorporate staff from other facilities 
                        to support the pilot program required under 
                        subsection (b); and
                            (ii) ensure adequate staffing to support 
                        the needs of veterans with a spinal cord injury 
                        or disorder;
                    (B) an assessment of medical equipment needs; and
                    (C) an assessment of the best location to deliver 
                treatment and health care under the mental health 
                residential treatment programs of the Department, 
                including through the use of spinal cord injury or 
                disorder centers and spinal cord injury or disorder 
                spokes.
    (b) Pilot Program.--Commencing not later than 120 days after the 
date of the enactment of this Act, the Secretary shall carry out a 
pilot program to provide access to mental health residential treatment 
programs of the Department for veterans with a spinal cord injury or 
disorder at not fewer than three medical facilities of the Department.
    (c) Report.--Not later than one year after the date of the 
enactment of this Act, the Secretary shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report on--
            (1) the implementation of the plan required under 
        subsection (a);
            (2) the initial results from the pilot program under 
        subsection (b); and
            (3) plans to expand the mental health residential treatment 
        programs of the Department to additional medical facilities of 
        the Department to address demand for the highly specialized 
        treatment provided under such programs for veterans with a 
        spinal cord injury or disorder.

SEC. 403. MENTAL HEALTH CONSULTATIONS AND OUTREACH ON MENTAL HEALTH 
              SERVICES FOR VETERANS RECEIVING COMPENSATION FOR 
              DISABILITIES RELATING TO MENTAL HEALTH DIAGNOSES.

    (a) Technical Corrections.--
            (1) In general.--The section 1167 of title 38, United 
        States Code, relating to mental health consultations, is 
        redesignated as section 1169.
            (2) Clerical amendments.--The table of sections at the 
        beginning of chapter 11 is amended--
                    (A) by striking the item relating to the section 
                1167 relating to mental health consultations; and
                    (B) adding after the item relating to section 1168 
                the following new item:

``1169. Mental health consultations.''.
    (b) Improvements.--Section 1169 of such title, as redesignated by 
subsection (a), is amended--
            (1) in subsection (a), in the subsection heading, by 
        striking ``In General'' and inserting ``Initial Mental Health 
        Consultations'';
            (2) by redesignating subsection (b) and (c) as subsections 
        (c) and (d), respectively;
            (3) by inserting after subsection (a) the following new 
        subsection (b):
    ``(b) Annual Mental Health Consultations and Outreach.--Not less 
frequently than once each year, the Secretary shall--
            ``(1) offer to each veteran who is receiving compensation 
        under this chapter for a service-connected disability relating 
        to a mental health diagnosis a mental health consultation to 
        assess the mental health needs of, and discuss other mental 
        health care options for, the veteran; and
            ``(2) conduct outreach to each veteran described in 
        paragraph (1) regarding the availability of consultations 
        described in such paragraph and other mental health services 
        from the Department.''.;
            (4) in subsection (c), as redesignated by paragraph (2), by 
        inserting ``or (b)'' after ``under subsection (a)'' both places 
        it appears; and
            (5) in subsection (d), as redesignated by paragraph (2), by 
        inserting ``or as requiring reevaluation of any entitlement of 
        the veteran to compensation under this chapter'' before the 
        period at the end.
    (c) Biennial Reports.--Such section, as amended by subsection (b), 
is further amended by adding at the end the following new subsection:
    ``(e) Biennial Reviews and Reports.--(1) Not later than one year 
after the date of the enactment of the BRAVE Act of 2024, and not less 
frequently than once every two years thereafter, the Secretary shall--
            ``(A) review the efficacy of the outreach of the Department 
        with respect to consultations offered under this section; and
            ``(B) submit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives a report on--
                    ``(i) the findings of the Secretary with respect to 
                the most recent review conducted pursuant to 
                subparagraph (A); and
                    ``(ii) the plans of the Secretary to address the 
                findings described in clause (i).
    ``(2) In order to facilitate reviews conducted under paragraph 
(1)(A), the Secretary shall--
            ``(A) ensure veterans can provide feedback to the Secretary 
        on outreach described in paragraph (1) and the consultations 
        offered under this section; and
            ``(B) analyze the feedback described in subparagraph (A) 
        that is provided to the Secretary.
    ``(3) Each review conducted pursuant to paragraph (1)(A) shall 
cover the following:
            ``(A) The feedback collected under paragraph (2).
            ``(B) Consultations sought pursuant to offers under this 
        section.
            ``(C) Matters that deter veterans from seeking 
        consultations offered under this section.''.

SEC. 404. JOINT REPORT ON EFFECTIVENESS OF PROGRAMS OF DEPARTMENT OF 
              VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE THAT PROMOTE 
              ACCESS TO MENTAL HEALTH SERVICES FOR TRANSITIONING 
              MEMBERS OF THE ARMED FORCES.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs and the 
Secretary of Defense shall jointly submit to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' Affairs of the 
House of Representatives a report on the actions taken or that will be 
taken by each such Secretary, either independently or jointly, to 
improve the effectiveness of programs of the Department of Veterans 
Affairs and the Department of Defense that promote access to mental 
health services for members of the Armed Forces transitioning from 
service in the Armed Forces to civilian life.
    (b) Status of Response to Comptroller General Recommendations.--The 
report required under subsection (a) shall include an assessment of the 
status of the response by the Secretary of Veterans Affairs and the 
Secretary of Defense to the recommendations of the Comptroller General 
of the United States set forth in the July 2024 report entitled ``DOD 
AND VA HEALTH CARE: Actions Needed to Better Facilitate Access to 
Mental Health Services During Military to Civilian Transitions'' (GAO-
24-106189).
    (c) Identification of Duplicative Efforts.--The report required 
under subsection (a) shall identify any duplicative efforts or gaps in 
services and recommend changes to programs of the Department of 
Veterans Affairs or the Department of Defense to address such 
duplicative efforts or gaps, including recommendations for legislative 
action.
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